益气和营方联合激素治疗特发性肉芽肿乳腺炎临床疗效及C3、C4免疫紊乱机制探讨  

Clinical Effect of Yiqi Heying Formula Combined with Hormone Therapy in Treating IGM and Mechanism of C3 and C4 Immune Disorder

作　　者：宿琦琦 刘晓菲 李斐斐 李静蔚[2] 陈翰翰[2] 王凤仪 李书园 张丽美[4] SU Qiqi;LIU Xiaofei;LI Feifei;LI Jingwei;CHEN Hanhan;WANG Fengyi;LI Shuyuan;ZHANG Limei(The First Clinical College,Shandong University of Traditional Chinese Medicine,Jinan 250014,China;Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China;TCM School of Shandong University of Traditional Chinese Medicine,Jinan 250014,China;Shandong Academy of Chinese Medicine,Jinan 250014,China)

机构地区：[1]山东中医药大学第一临床医学院,山东济南250014 [2]山东中医药大学附属医院,山东济南250014 [3]山东中医药大学中医学院,山东济南250014 [4]山东省中医药研究院,山东济南250014

出　　处：《中医药学报》2022年第8期48-53,共6页Acta Chinese Medicine and Pharmacology

基　　金：国家重点研发计划中医药现代化项目(2018YFC1704103);山东省医药科技发展计划项目(2018WS191);山东省重点研发计划项目(2015GSF119014);山东省中医药科技发展计划项目(2019-0159);2018年第六批全国老中医药专家学术经验传承工作项目。

摘　　要：目的:通过对初期特发性肉芽肿乳腺炎病例的观察,探讨益气和营方联合激素治疗的疗效和优势,同时初步验证外周血及病变组织中C3、C4免疫紊乱机制。方法:选取80例初期肉芽肿性乳腺炎患者,随机分为激素组、中药+激素组,每组40例。治疗期间定期观察乳房肿块大小、肿块疼痛评分,治疗后计算临床总有效率,治疗前后检测血清C3、C4水平,免疫组化法检测病变组织C3、C4阳性表达水平。结果:中药+激素组较激素组更有效缩小肿块、缓解疼痛(P<0.01),中药+激素组临床总有效率明显高于激素组(P<0.01),中药+激素组较激素组更能降低外周血C3、C4水平,更能降低病变组织内C3、C4的阳性表达水平(P<0.05)。结论:中西医结合治疗特发性肉芽肿乳腺炎临床疗效显著,特发性肉芽肿乳腺炎外周血和局部病变组织内均存在C3、C4免疫紊乱,益气和营中药联合激素治疗可以更好地改善C3、C4免疫紊乱状态。Objective:To investigate the efficacy and advantages of Yiqi Heying Formula combined with hormone therapy in treatment of idiopathic granulomatous mastitis(IGM),and to verify the mechanism of C3 and C4 immune disorders in peripheral blood and pathological tissues.Methods:80 patients with early IGM were randomly divided into the control group and the study group,with 40 cases in each group.The control group was treated with hormone therapy;on which basis,the study group was also treated with Yiqi Heying Formula.During the treatment period,the size and pain score of the breast mass were observed regularly,and the total clinical effective rate was calculated after the treatment in the two groups.Serum levels of C3 and C4 were detected before and after the treatment,and the positive expression levels of C3 and C4 in the lesion tissues were detected by immunohistochemical method,and each indicator was analyzed statistically.Results:The size of breast mass was significantly reduced and the pain was effectively relieved in the study group compared with those in the control group(P<0.01).The total effective rate was obviously higher in the study group than that in the control group(P<0.01).Peripheral blood levels of C3 and C4,as well as positive expressions of C3 and C4 in the pathological changes were significantly reduced compared with those in the study group(P<0.05).Conclusion:The clinical effect of integrated Chinese and western medicine is significant in treatment of IGM.C3 and C4 immune disorders exist in peripheral blood and local lesion tissues of IGM.Yiqi Heying Formula combined with hormone therapy can better improve C3 and C4 immune disorders.

关 键 词：特发性肉芽肿乳腺炎 益气和营方 激素治疗 C3 C4 免疫紊乱 

分 类 号：R271.44[医药卫生—中医妇科学]